Detection of local antibody response in urine as a tool for diagnosis of urinary tract infection

ABSTRACT

Identifying urinary tract infection [UTI] is based mainly on culture of uropathogens which may take at least 3 days before a final report is issued. We tried to study the possibility of identifying UTI by the detection of local antibodies [IgG and IgA] in urine. A total number of 69 patients complaining of dysuria, frequency, loin pain and or suprapubic pain were examined urologically and midstream urine sample was collected from each patient. The urine samples were examined microscopically for pus cells, RBCs and crystals. They were also cultured quantitatively and assayed for local IgG and IgA antibodies in urine to common urinary pathogens. The 69 patients had significant pyuria, 50 patients showed positive urine culture E. coli [27], Klebsiella [13], Staphylococcus saprophiticus [8] and Proteus 2 patients. From the 50 patients 48 had positive local specific urinary antibodies and 2 were negative for the local urinary antibodies. The 19 patients with negative urine culture 15 had positive local urinary antibodies. The control group 13 subjects had no pus in urine, negative culture and negative local antibodies. Two subjects had. no pus, positive culture [E. coli] and positive local antibodies. In conclusion the local specific IgG and IgA to common uropathogens could help in the primary identification of UTI and thus the clinical doctor can initiate a blind antibiotic treatment, till culture and sensitivity results are obtained. Since it is possible to identify UTI with the positive results of the local antibodies in urine of symptomatizing patients with significant pyuria. Also it could help in screening asymptomatic bacteruria